Sr. Project Manager, Claims Processing

Regal Medical Group•Los Angeles, CA

28d

About The Position

Sr. Project Manager – Claims Processing Provide direct support to the SVP, Claims Processing on professional claims projects, collaborating with IT, Data Management, and Decision Support teams to resolve issues efficiently. Apply standardized project management tools, methodologies, and templates for deliverables such as timelines, milestone reports, budgets, and resource tracking. Manage all project phases including scope planning, analysis, scheduling, budgeting, risk management, implementation, and post-project evaluation. Maintain consistent communication with claims staff, vendors, consultants, and leadership; coordinate activities across departments to ensure project alignment. Mentor and support team members, promoting active engagement and accountability throughout the project lifecycle. Identify and mitigate project risks; escalate critical issues for resolution when necessary and implement strategies to prevent recurrence. The pay range for this position at commencement of employment is expected to be between $70,304 - $75,000 annually; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors. As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. Full Time Position Benefits: The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life. Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options. Health and Wellness: Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement: 401k Retirement Savings Plan Income Protection Insurance Other Benefits: Vacation Time Company celebrations Employee Assistance Program Employee Referral Bonus Tuition Reimbursement License Renewal CEU Cost Reimbursement Program Business-casual working environment Sick days Paid holidays Mileage Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

Requirements

5+ years of claims processing experience in a healthcare environment, preferably using EZ-CAP or comparable systems
5+ years of experience in the healthcare industry, with exposure to claims operations and related processes
Strong ability to partner with management and project managers to define business process issues, analyze operational efficiency, implement creative solutions, and track measurable results
Demonstrated disciplined, process-driven and data-driven approach to work and decision-making.
Proven ability to conduct and interpret both qualitative and quantitative analyses, with strong problem-solving skills.
Working knowledge of claims payment policies and their application in day-to-day adjudication is preferred.
Strong PC skills with business software, including Microsoft Access, Excel, PowerPoint, and Word.
Excellent verbal, written, and presentation skills, with the ability to communicate clearly at all levels of the organization.
Ability to work effectively with individuals at all organizational levels and act as a strong team player.
Highly organized, with strong time-management skills and the ability to prioritize multiple tasks while working with minimal supervision
Demonstrated initiative, independent judgment, and a self-starter mindset in driving projects forward.

Responsibilities

Provide direct support to the SVP, Claims Processing on professional claims projects, collaborating with IT, Data Management, and Decision Support teams to resolve issues efficiently.
Apply standardized project management tools, methodologies, and templates for deliverables such as timelines, milestone reports, budgets, and resource tracking.
Manage all project phases including scope planning, analysis, scheduling, budgeting, risk management, implementation, and post-project evaluation.
Maintain consistent communication with claims staff, vendors, consultants, and leadership; coordinate activities across departments to ensure project alignment.
Mentor and support team members, promoting active engagement and accountability throughout the project lifecycle.
Identify and mitigate project risks; escalate critical issues for resolution when necessary and implement strategies to prevent recurrence.